i hate med school Flashcards
1
Q
phenytoin
A
zero order kinetics
2
Q
malformation
A
poor formation of tissue
3
Q
ex of incomplete morphogenesis
A
spina bifida
cleft palate
4
Q
ex of recurrent morphogenesis
A
having 18 toes (polydactyly)
ear tags
5
Q
ex of aberrant morphogenesis
A
ectopic thyroid
6
Q
deformation + examples of it
A
unusual forces on normal tissue
club foot
potter sequence (stockings over face disease)
7
Q
disruption + examples of it
A
breakdown of normal tissue
digital amputations
vascular accidents that cause ischemia/necrosis
8
Q
are deformations lethal
A
rarely
9
Q
what is a sequence?
A
when one anomaly triggers a sequence of other anomalies
(spina bifida triggers something downstream, i dont know what)
10
Q
what does TORCH stand for
A
T oxoplasmosis
O h no, I have syphillis!
R ubella
C ytomegalovirus
H erpes
11
Q
memantine
A
open channel blocker
glutamate NMDA
(for glutamate-gated Ca2+ channel)
tx alzheimers
12
Q
AMPA/kaitine channel for what NT?
inh or excitatory?
A
glutamate
excitatory
13
Q
ondasteron
molec mechanism
what does it treat
A
5HT3 serotonin blocker
anti emetic after cancer
14
Q
benzos
A
allosteric activators of GABA-A
15
Q
penicillin effect on NT channel
what does it cause?
A
open channel blocker of GABA-A
causes seizures
16
Q
strychnine
A
comp inh of glycine receptor
17
Q
tetanus toxin
A
inh glycine release
18
Q
hyperekplexia
A
familial startle disease
glycine channels mutated, no inh stimulus
19
Q
competitive inh
A
decrease potency, incr EC50
no change in efficacy
20
Q
non-comp inh
A
EC50/potency same
decreased efficacy
21
Q
uncomp inh
A
decrease efficacy
decr EC50 (incr potency)
22
Q
ex of receptor that follows constrained subunit model
A
Nicotinic ACh
23
Q
ex of receptors that follow sequential change model
A
ionotropic glutamate receptors
GPCRs
24
Q
EPSPs/EPPs
A
activation of NT receptor permeable to Na/Ca causes depolarization
25
IPSPs
activation of NT receptor permeable to Cl- causes membrane hyperpolarizaiton
26
what is resting membrane potential established by?
Na/K ATPase
k+ leak channels
27
describe neuronal action potential + refractory period
28
for cardiac AP, blocking Na+ channels does what?
blocks upstroke
29
for cardiac AP, blocking K+ channels does what?
longer AP duration (incr repol time)
30
for cardiac AP, blocking Ca2+ channels does what?
shorter AP duration (decreased repol time)
31
terfenadine
off target effect blocked hERG K+ channels --\> long QT
people died
32
sulfonylurea
tx diabetes by binding to and inh KATP channels
33
what causes KATP channels to close?
what happens when they are closed?
ATP binding, or sulfonylurea binding
causes depol of membrane + opening of Ca2+ channels
vasoconstricition or insulin release
34
minoxidil
anti HTN
vasodilation
activates & opens KATP channels
35
tropine/tropium drugs
muscarinic Ach antagonists
increase HR
36
what histologic change happens during breastfeeding?
lobular hyperplasia
37
B1 vs B2 effects
one heart (b1) two lungs (b2)
38
what pathway for growth factors?
RAS/MAPK
(MAPk = mitogen activated protein kinase)
39
what pathway for insulin?
| (RTK)
PI3K/AKT/mTOR
40
what pathway for cytokines (RTK)
JAK/STAT
41
explain RTK pathway (general) for RAS/MAPK and PI3K/AKT/mTOR
ligand binds
receptors dimerize
receptors transphosphorylate on Tyr residues
scaffold binds
kinase cascade initiated
42
explain RTK pathway for JAK STAT
ligand binds STAT
JAK proteins bind and phosphorylate Tyr residues, also serve as scaffold
pSTATs go into nucleus and do things
43
what do allosteric activators do in regard to receptor desensitization?
decrease likelihood
44
do ligand channels desensitize
yes, rapidly to orthosteric agonistsf
45
do GPCRs desensitize?
yes
cytoplasmic tail gets phosphorylated by GRKs
p tail binds b-arrestin
singaling gets arrested
receptor gets internalized
46
ex of biased ligand...
angiotensis II biased agnoists for cytoprotection
47
ex of continuous epithelium
blood brain barrier
48
fenestrated endothelium ex
GI tract, endocrine glands, capillary
49
sinusoidal epithelium ex
spleen, BM, liver
50
is p-glycoprotein an ABC or SLC
ABC
51
what are 3 major roles of p-glycoprotein
eliminate drugs from the brain
reduce GI absorption
excrete drugs in bile and urine
52
SLC6s do what?
reuptake NTs at synapse
53
apparent volume of distribution (Vd)
total amt of drug administered/ plasma conc
54
weak acids bind which blood protein?
albumin
55
weak bases bind which blood protein?
alpha-acid glycoprotein
56
what bad thing does H2 blocker cimetidine do?
inhibits lots of CYPs
57
prototypical exampls of metabolism via CYP3A4 = these drugs
azolam benzos (midazolam)
58
caffeine and theophylline are...
competitive inh of adenosine (adenosine receptor antagonists)
59
what happens when you have TPMT polymorphisms that cause TPMT deficiency?
TPMT normally puts brakes on thiopurine --\> thioguanine rxn
no TPMT = accumuation of toxic thioguanine
60
azolam CYP?
3A4
61
azepam CYP?
3A4, 2C19
62
furanocoumarins do what?
grapefruit juice, inh CYP3A4
63
St Johns wart does what?
induces CYP3A4
induces CYP2C19
induces CYP2C9
induces CYP2E1
induces p glycoprotein
64
echinacea does what?
induces CYP3A4
65
what drug metabs are affected by having CYP2D6 polys?
metoprolol
opioids (codeine)
CNS drugs
66
prazole CYP?
2C19
67
ginkgo does what?
induces CYP2C19, 2C9
68
warfarin CYP
2c9
69
NSAID CYP
celecoxib
2c9
70
what does high dose of EtOH induce ?
CYP2E1
71
tetrodotoxin does ?
blocks voltage gated Na+ channels in nerve and muscle
72
local anesthetics do what?
block voltage gated Na+ channel, preventing AP
preferentially bind to inactivated state of channel
73
clopidogrel
anti clotting
prodrug
susceptible to CYP2C19 variants
74
when should we collect blood for therapeutic drug monitoring?
pre-dose (trough conc)
peak conc
once randomly
75
would we do TDM for warfarin?
no, we can look at INR
76
theophylline
competitive inh of adenosine
77
lateral plate becomes...
body cavities, gut wall
78
intermediate mesoderm becomes...
urogenital
79
paraxial mesoderm becomes..
somites for muscles, bone, and connective tissue
80
somatopleure
body wall, ecto side of meso
81
splanchnopleure
visceral wall, endo side of meso
82
when does EC50 = Kd for BIOLOGICAL response?
for partial agonists and ligand gated channels
83
zolpidem
positive allosteric modulator of gaba-a, binds to benzo binding site
84
cimetidine
histamine H2 blocker, inh all CYPs except for CYP2E1
85
quinidine-digoxin interaxn
quinidine impairs digoxin renal clearance by competing for p-glycoprotein in proximal tubule
86
quinidine-loperamide interaxn
quinidine impairs loperamide efflux from BBB leading to risk of resp depression
87
ritonovir tenofivir interaxn
ritonovir inhibits MRP2 and MRP3 efflux transporters in proximal tubule and impairs elimination of phospho-tenofivir
88
probenecid oseltavivir penicillin intraxns
probenecid impairs renal elimination of penicillin and oseltavivir
(GOOD- delays excretion of valuable drugs)
89
CYP for tacrolimus
CYP3A5
90
albuterol
B2 agonist, relaxes airway smooth muscle
91
metoprolol
anti-HTN, selective B1 blocker
92
N-acetylcysteine
GSH analog, saves liver from evil NAPQI
93
why shouldn't you drink and take acetaminophen?
EtOH induces CYP2E1 ---- NAPQI
EtOH reduces GSH, no rescue
:(
94
lorazepam what type of drug?
why give it to old people?
benzodiazepine
give it to old people because it's only metabolized by glucuronidation
(CYP function declines in the elderly so drugs that are substrates for CYPS are not good candidates)
95
where are microvilli?
intestinal brush border
kidney PCT
96
where are stereocilia?
male reproductive
97
where are cilia?
epithelial lining of respiratory tract
female repro sys
98
tight junctions made of
claudins and occludins
99
adherens junctions made of
cadherins
100
what is macula adherens?
what's it made of?
desmosome
made of cadherins
101
what are gap junctions made of
connexons
102
deep body wall nerves consist of
somatomotor neurons
general sensory neurons
sympathetic neurons
103
superficial body wall nerves consist of
general sensory neurons
sympathetic neurons
104
sympathetic does:
prepares the body for exertion: contracts arteries, raises BP, increases HR, dilates airway and pupils
105
parasympathetic does:
rest and digest
lowers BP/HR, constricts airway/pupils/GI smooth muscle to trigger peristalsis, triggers glandular secretion
106
cell body of somatomotor neuron
ventral horn of spinal cord
107
cell body of sensory neuron (general + visceral)
DRG
108
cell body sympathetic neuron
1 is in lateral horn T1-L2
2 is either in sym trunk (spinal nerves, thorax) or collateral ganglia (abdominal viscera)
109
cell body parasympathetic neuron
1 is either in brain or lateral horn
2 is in wall of organ innervated
110
